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What do you say or do if dementia patient says she is crazy all the time? Do you tell them what is wrong?

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No, they will not be able to process that information. And repeating each time this happens will not help either. Just be supportive with responses like "no, you aren't, I am sorry you aren't feeling well today, we all forget sometimes". Then redirect to talk or do something she likes to do.
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My MIL(without dementia) used to worry a lot when she forgot something. I used to tell about the most recent things I'd forgotten myself and we would laugh together.
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I think she must know there is something wrong. I imagine it would make me feel even more crazy if people kept telling me "No, you aren't crazy. Everything is fine." when I knew something was wrong with me.

Maybe you could ask her some questions about why she is saying it at that time? Maybe if you can validate that something IS wrong, she's ill and having a symptom but that she is safe and you have things under control it would be comforting to her?

Teepa Snow suggests "I'm sorry. I know this is hard. "
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